A nurse at a community health center is preparing a presentation on alcohol use disorder. Which of the following risk factors should the nurse include in the presentation?

A. Encourage the client to take naps during the day: While daytime napping may help the client rest, it is unlikely to directly prevent nighttime wandering. It might even interfere with nighttime sleep, potentially increasing wandering behavior.
B. Install locks at the bottom of the exit doors: Installing locks at the bottom of exit doors is an effective safety intervention. It can prevent the client from wandering outside while still allowing caregivers to monitor and assist the client if needed.
C. Place the client's mattress on the floor: Placing the mattress on the floor might prevent injury if the client falls out of bed, but it does not address the core issue of nighttime wandering. Additional measures are needed to manage wandering safely.
D. Place rubber-backed throw rugs on tile floors: Rubber-backed throw rugs can help prevent slipping but do not directly address the issue of wandering. This intervention may be useful for fall prevention but not for preventing the client from wandering at night.

Rationale for correct choices:

• Mood: The client demonstrated a sad mood on Day 1, expressing feelings of hopelessness and suicidal ideation. While the mood lightened by Day 5, continued assessment is necessary to monitor for any further mood changes or shifts, particularly given the prior suicidal ideation.
• Energy level: The client is now requesting to jog and asking for financial planning recommendations, which could suggest increased energy or impulsivity. This shift in energy level after a depressive episode should be carefully assessed to ensure it is not indicative of a manic episode or potential risk for unsafe behavior.

Rationale for incorrect choices:

• Cognitive orientation: The client has been alert and oriented x 4 throughout the assessment, with no signs of cognitive impairment. Therefore, there is no immediate concern regarding cognitive orientation that requires follow-up.
• Family history: Although the family history of anxiety disorder is relevant for understanding the client’s background, it does not require immediate follow-up in this scenario. The priority is addressing the client's current emotional and energy-related changes.
• Substance use history: While the client has a history of opioid and cannabis use, this is important for overall treatment planning and future care. However, the immediate concern is the client's current emotional state and potential changes in mood or energy, rather than a substance use history that has already been considered in the client’s care plan.